INR of 8.3 What does this mean?
What an INR Level of 8.3 means
What happens when your blood is "dangerously thin"
Having blood that is "dangerously thin" means you are at a greater risk of internal bleeding. You should report any falls or accidents, as well as signs or symptoms of bleeding or unusual bruising to your healthcare provider.
The most serious internal bleeding can happen in your stomach or head.
Serious Internal Bleeding Symptoms
- An unusual or severe headache may signal intracerebral bleeding (bleeding in the head)
- A severe stomach ache may signal gastrointestinal bleeding (bleeding in the stomach)
Excessive bleeding can occur in any area of the body.
Other Internal Bleeding Symptoms
- Prolonged bleeding after minor cuts
- Prolonged menstrual bleeding
- a nosebleed
- vomiting blood
- bleeding from the gums
- Blood in urine
- Bloody or dark stool
Bleeding Inside the Head
Your INR is 8.3 and is greater than or equal to 4.5. If this continues for prolonged periods of time, the chance of bleeding inside the head increases significantly.4
Treatment for an INR of 8.3
Since your international normalized ratio (INR) is outside your therapeutic range, your doctor may opt to adjust your current Warfarin therapy plan.
DO NOT attempt to self-medicate. ALWAYS consult your doctor and follow his/her treatment plan.
These are some scenarios you may experience:
Pausing Your Warfarin Dosages
Your doctor may want you to stop taking (hold) Warfarin temporarily and see him/her immediately.6
When Your INR is 20 or higher
When your INR is this high, then your doctor should be taking it seriously. Your doctor should be do the following things to bring down your INR.
When your INR is dangerously out of its target range then a rapid reversal of your blood thinning therapy is required.
Your doctor will give you a prothrombin complex concentrate and 10 mg of vitamin K1 by infusion. Your doctor may repeat if needed.
A prothrombin complex concentrate is a combination of blood clotting factors prepared from fresh-frozen human blood plasma. It's used to reverse the effects of Warfarin when bleeding occurs (e.g. in the brain or gut) requiring rapid action to accelerate coagulation.1
Mini Dose of Vitamin K
Your doctor may consider giving you a mini-dose of oral Vitamin K to bring your 8.3 INR down into your target INR range.10
Decreasing Your Normal Dosage
If there isn't a clear explanation for your INR of 8.3 to be out of your target INR range, then your doctor would decrease your Warfarin maintenance dose by 5%–15%. The doctor will want to recheck your INR in 4 to 7 days.6, 10
If You Are not Bleeding and Are Not Having Surgery Soon
Your doctor is going to want to monitor your INR more frequently, will likely have you omit your next 1-2 dosages and will restart you at a lower dosage when your INR approaches your target range. Your doctor may orally give you 1-2.5 mg of Vitamin K1. Your doctor is going to want to monitor your INR more frequently until your INR stays consistently in your target range.1
If You Aren't Bleeding But Are Having Surgery in 24 Hours
If you're having surgery in 24 hours, your INR can't be VERY HIGH.Your doctor will give you 2–4 mg of Vitamin K1 orally with the expectation that your INR will go down within 24 hours. After 24 hours, if your INR is not back to your target range, your doctor may give an additional 1–2 mg of Vitamin K1. Your doctor is going to want to monitor your INR more frequently until your INR stays consistently in your target range.1
If You're Experiencing Life-threatening Bleeding
How long an INR of 8.3 will last
When you should have another INR test
Since your INR of 8.3 is out of the target range you should test frequently until your INR Level is in its target range. This could be every 4 to 7 days.2
These are some additional reasons you may need to test your INR more frequently:
When You First Begin Warfarin Therapy
Changes To Your Medications or Condition
When You Use Warfarin and Heparin at the Same time
Reasons your INR can fluctuate
Your INR of 8.3 is higher than your target INR range, and the following interactions could be reasons for that.
Vitamin K and your INR
If your diet changed and you took less vitamin k than you normally do, then your INR will have gone up.
It is important to have Vitamin K in your diet. The USDA recommends 90 mcg of Vitamin K every day. However, Vitamin K impacts your INR. So you should aim to have the same amount each day.
Not having any vitamin k in your diet is bad advice, because then if you falter in your diet and have some vitamin k, your Warfarin therapy would interact with the sudden increase in vitamin k. Also, vitamin k is an important vitamin.
Supplements That Increase your INR13
|Dong Quai||Coumarin derivative|
|Red Yeast Rice|
Drugs That Increase Your INR11
|Carbamazepine||Carbatrol©, Epitol©, Equetro©, Tegretol©, Tegretol©– XR, Teril©|
|Nafcillin||Nallpen© In Plastic Container|
|Omeprazole||Nexium©, Prilosec©, Prilosec© OTC, Zegerid©, Zegerid© OTC|
|Pioglitazone||Actoplus© Met, Actoplus© Met XR, Actos©, Duetact©, Oseni©|
|Rifampin||Rifadin©, Rifamate©, Rifater©, Rimactane©|
Alcohol And Your INR
Binge drinking alcohol will bring your INR up. Drinking 1-2 drinks will bring your INR down.13
Cranberry Juice and Grapefruit Juice
UC San Diego Anticoagulation Clinic recommends, in general, an interaction between warfarin and cranberry products is NOT expected. What they advise, as with everything, is moderation - have a glass, not a gallon of cranberry juice.
The same goes for grapefruit juice.13
Supplements / Foods
The following can increase the risk of bleeding because of their antiplatelet effect.13
- Fish Oil/Omega 3 Fatty Acids
Drugs That Increase the Risk of Bleeding11
|Drug||Brand Name(s)||Type of Drug|
|celecoxib||Celebrex©||Nonsteroidal Anti-inflammatory Agents|
|diclofenac||Arthrotec©, Cambia©, Cataflam©, Voltaren©-XR, Zipsor©||Nonsteroidal Anti-inflammatory Agents|
|diflunisal||Nonsteroidal Anti-inflammatory Agents|
|fenoprofen||Nalfon©||Nonsteroidal Anti-inflammatory Agents|
|ibuprofen||Advil©, Midol© Liquid Gels, Motrin©, Profen©, Tab-Profen©||Nonsteroidal Anti-inflammatory Agents|
|indomethacin||Indocin©||Nonsteroidal Anti-inflammatory Agents|
|ketoprofen||Nexcede©||Nonsteroidal Anti-inflammatory Agents|
|ketorolac||Sprix©||Nonsteroidal Anti-inflammatory Agents|
|mefenamic acid||Ponstel©, Treximet©, Vimovo©||Nonsteroidal Anti-inflammatory Agents|
|naproxen||Aleve©, Anaprox©, Anaprox© DS, EC-Naprosyn©, Naprelan©, Naprosyn©||Nonsteroidal Anti-inflammatory Agents|
|oxaprozin||Daypro©||Nonsteroidal Anti-inflammatory Agents|
|piroxicam||Feldene©||Nonsteroidal Anti-inflammatory Agents|
|sulindac||Clinoril©||Nonsteroidal Anti-inflammatory Agents|
|dipyridamole||Aggrenox©, Persantine©||Antiplatelet Agents|
|citalopram||Celexa©||Serotonin Reuptake Inhibitors|
|desvenlafaxine||Pristiq©||Serotonin Reuptake Inhibitors|
|duloxetine||Cymbalta©||Serotonin Reuptake Inhibitors|
|escitalopram||Lexapro©||Serotonin Reuptake Inhibitors|
|fluoxetine||Prozac©, Prozac© Weekly, Sarafem©, Symbyax©||Serotonin Reuptake Inhibitors|
|fluvoxamine||Luvox©, Luvox© XR||Serotonin Reuptake Inhibitors|
|milnacipran||Savella©||Serotonin Reuptake Inhibitors|
|paroxetine||Paxil©, Paxil© CR, Pexeva©||Serotonin Reuptake Inhibitors|
|sertraline||Zoloft©||Serotonin Reuptake Inhibitors|
|venlafaxine||Effexor© XR||Serotonin Reuptake Inhibitors|
|vilazodone||Viibryd©||Serotonin Reuptake Inhibitors|
What a target INR range of 2 to 3 means
- Treatment for deep vein thrombosis (DVT) - blood clot in leg
- Treatment for pulmonary embolism (PE) - blood clot in lung
- Prophylaxis of venous thrombosis (high-risk surgery)
- Tissue heart valves
- Acute Heart Attack
- Valvular heart disease
- Atrial fibrillation
When You Are in Your Target INR Range
Staying inside your target INR range of 2 to 3
Your INR of 8.3 is out of your target range. Due to Warfarin's unpredictable pharmacokinetics, studies have found that patients only spend about 60% of time within the therapeutic range.5
Since your INR Level is out of its target range your doctor will likely make dosage adjustments. However, make sure your doctor is taking into account the 4 D's! 3
Tell Your Doctor About Your 4 D's
These factors may be the reason your INR being out of its target range:
- Diet - any major changes (fasting, weight watchers), liver or 7 consumption?
- Drugs - any new medicines, discontinued medicines since last INR check?
- Dose - confirm current Warfarin dose, any missed doses?
- Disease - any recent illness, fever, N/V/D, significant pain or stress?
Antibiotics/Antifungals and High INR Levels
Whether you are taking a topical antibiotic or one in pill form, antibiotics can suddenly elevate your INR.11, 12
"A patient could be stable at 2.5, and with an antibiotic, jump to 5. At this level, the risk of gastrointestinal bleeding increases, and a bump on the head could become a bleed in the brain," says Dr. Tejal Gandhi, associate professor of medicine at Harvard Medical School and an expert on outpatient drug safety.
It is important to regularly have an INR test when you are taking an antibiotic/antifungal with Warfarin because the effect of an antibiotic/antifungal on any individual cannot be predicted. Your doctor may reduce your dosage if he/she sees a spike in INR due to the antibiotic.
"It is most important to monitor Warfarin patients as soon as they start a new antibiotic. If we see a small rise in INR with a two to three-day course of prophylactic antibiotics before dental work, we may not worry, because the antibiotic leaves the system quickly. However, if we see an upward rise in INR with a common, broad-spectrum antibiotic such as erythromycin or ciprofloxacin, we must decide whether we need to adjust the dose downward and continue monitoring the patient," says Lynn Oertel, clinical nurse specialist for the anticoagulation management service at Massachusetts General Hospital.
Antiphospholipid Antibodies will throw your INR off!
If you have Antiphospholipid antibodies (lupus anticoagulants) in your body, then you may experience incorrect INR results. There are special INR machines designed to more accurately measure an INR for someone with Antiphospholipid antibodies. It is important to test whether you have Antiphospholipid antibodies so your doctor can take this into account. This is also called Hughes Syndrome.
The APS Foundation of America recommends that if you have APS, then your INRs should be checked from blood drawn from a vein and tested in a laboratory rather than from finger stick machines. It's important that your INR reading is correct, because if you're treated for an incorrect INR, it could have dire consequences.
How Warfarin "thins" the blood
Other INR Levels near your INR of 8.3
- INR of 7.9 - what it means
- INR of 8.0 - what it means
- INR of 8.1 - what it means
- INR of 8.2 - what it means
- INR of 8.4 - what it means
- INR of 8.5 - what it means
- INR of 8.6 - what it means
- INR of 8.7 - what it means